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Epidural to relieve labor pain

An epidural block (also called epidural) is the most popular and effective kind of pain relief for labor. With an epidural, you get a needle with a small tube placed in your lower back. Medicine goes through the tube and numbs your lower body so you can’t feel labor pain. The medicine doesn’t make you go to sleep, so you can be awake when your baby is born.

You may want medicine like an epidural to help with labor pain. Or you may want to have natural childbirth without medicine. Talk to your health care provider about all your pain-relief options to decide which is right for you. Write your pain-relief choices on your birth plan and share it with your provider and with the staff at the hospital or birthing center where you plan to have your baby. A birth plan is a set of instructions you make about your baby’s birth.

How do you get an epidural?

Here’s what happens:

Your provider numbs your lower back with a local anesthetic. This is a medicine you get that prevents you from feeling pain. Local means that it only works in a small spot, not for your entire body.

You sit or lie on your side with your back curved outward.

Your provider inserts a needle into your lower back and then passes a small flexible tube (called a catheter) through the needle. You may feel some pressure as the needle goes in, but it usually isn't painful.

Your provider removes the needle. The tube stays in place, and medicine goes through the tube while you’re in labor.

You can get an epidural during active labor. You also may get an epidural if you’re having a cesarean birth (also called c-section). A c-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus (womb).

It takes about 20 minutes to get an epidural and another 10 to 20 minutes for it to take effect. Even though you don’t feel pain, you may still be aware of contractions. You also may feel your provider checking you internally as your labor progresses.

Depending on how much pain relief you need, the epidural can block all pain in your lower body or just change your awareness of the pain. It may cause your legs to feel numb or weak, so you probably can’t walk around once the epidural takes effect. You may want to get a walking epidural, which relieves pain but leaves you with enough strength in your legs to walk during labor.

What are some pros and cons of having an epidural?

Learning about the pros and cons of an epidural can help you decide if it’s the right pain-relief method for you.

Pros

An epidural can be used throughout labor and for several hours.

It lets you stay awake and alert.

It usually has little or no effect on your baby.

Cons

An epidural may make your labor last longer (prolong your labor).

It may provide uneven pain relief. For example, it may affect one side of your body more than the other.

Your blood pressure may drop during an epidural. This may affect your baby's heartbeat. To help prevent this, you can lie on your side to help improve blood flow. And you may get fluids through an intravenous (also called IV) tube.

You may feel some soreness in your lower back where the epidural was placed. This may last a few days.

If you get too much medicine, it may affect your chest muscles, and you may have trouble breathing. This rarely happens.

You may get a bad headache. If not treated, this "spinal headache" may last for days. This rarely happens.

Can you get an epidural even if you try to have natural childbirth?

Yes. Labor pain affects each woman differently. You may have mild discomfort or you may have intense pain. If you try natural childbirth and decide during labor to use pain medicine, it’s OK. Only you know how strong the pain feels. You can ask for pain relief at any time during labor.

Last reviewed April 2014

Frequently Asked Questions

What is an epidural?

An epidural is the most popular and effective kind of pain relief for labor. You get a needle with a small tube attached placed in your lower back. Medicine goes through the tube while you're in labor. It numbs your lower body so you can't feel the pain from your contractions. The medicine doesn't make you go to sleep, so you can be wide awake when your baby is born!

What is fetal-scalp blood sampling?

Fetal-scalp blood sampling is a quick test your health care provider can use to check if your baby is getting enough oxygen during labor.

During labor, your cervix dilates (opens) to let your baby out. Your cervix is the opening to the uterus that sits at the top of the vagina. In order to have fetal-scalp blood sampling, your cervix must be dilated enough that your provider can reach your baby’s head.

The test may remind you of a pelvic exam. It takes about 5 minutes. You lie on your back with your feet in stirrups. Your provider places a plastic cone in the vagina that fits up against the baby’s head. Your provider pricks your baby’s scalp and takes a small amount of blood. The blood is tested, and results are ready in a few minutes.

You may feel some pressure during the test, but it shouldn’t hurt. Your baby may have some bruising or bleeding at the spot where he’s pricked.

If you have an infection, like HIV or hepatitis C, your provider may not recommend fetal blood sampling. This is because you can pass these infections to your baby through the spot where he’s pricked.

What is oxytocin?

Oxytocin is a hormone your body makes to help start labor contractions. Contractions are when the muscles of your uterus get tight and then relax. They help push your baby out of your uterus (womb).

Your body also makes oxytocin during breastfeeding. Oxytocin helps your uterus shrink back to its original size after giving birth.

If labor is slow to start or your contractions stall, your health care provider may give you a medicine called Pitocin. Pitocin acts like oxytocin and can help start contractions or make them stronger.

What is Pitocin?

Pitocin is a medicine that acts like oxytocin, a hormone your body makes to help start labor contractions. Contractions are when the muscles of your uterus get tight and then relax. They help push your baby out of your uterus (womb). Health care providers often use Pitocin to:

Help labor move along if your contractions slow down, or if they aren’t strong enough

You may start having labor contractions shortly after you get Pitocin. It can make your contractions very strong and lower your baby's heart rate. Your provider carefully monitors your baby's heart rate for changes and adjusts the amount of Pitocin you get, if needed.

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